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degeneration of the MSK system with age Flashcards

(12 cards)

1
Q

ageing

A
  • affects the balance of mechanisms which ensures homeostasis within organs
  • alters tissue response to injury
  • associated with accumulation of genetic damage
  • elicits antagonistic/compensatory mechanisms- initially beneficial but chronicity leads to further damage- results in phenotype alterations
  • may overlap with pathological syndromes
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2
Q

generic processes with ageing

A
  • decreasing amount of tissue
  • altered molecular disposition of matrix
  • accumulation of degraded molecules
  • reduced efficiency of functional tissue elements
  • reduced synthetic capacity of differentiated cells
  • altered levels of trophic hormones, growth factors/cytokines
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3
Q

consequences of MSK ageing

A

Altered gait and balance leading to falls and fear of falls

Increased risk of injury, particularly fracture

Chronic pain in 50% of community dwelling elderly and 80% of those in care

Social isolation if living independently

Loss of independence and admission to care home

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4
Q

osteoarthritis

A

A disorder of synovial joints which occurs when damage triggers repair processes leading to structural changes withina joint

The most common joint disease world wide affecting 18% of women and 10% of men over the age of 60yrs

A complex and multifactorial condition involving genetic, biological and biomechanical factors which affect risk

Concept of simple “wear and tear” damage now outmoded
Knee > hip > hands and wrists > ankle and foot

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5
Q

osteoarthiritis - pathogenesis

A

draw out

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6
Q

treatment of osteoarthiritis

A
  • therapeutic exercise and weight management
  • topical NSAIDs for knee
  • oral NSAIDs considered but long term risk taken to account
  • paracetamol/weak opioids for short term pain relief
  • intra-articular steriods (short term)
  • consider joint replacement
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7
Q

osteoporosis

A

A progressive bone disease characterised by low bone mass and microarchitectural deterioration of bone tissue which leads to an increased risk of fragility fractures

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8
Q

boen remodelling

A

Activation: preosteoclasts are stimulated and differentiate under the influence of cytokines and growth factors into mature active osteoclasts

Resorption: osteoclasts digest mineral matrix (old bone)

Reversal: end of resorption

Formation: osteoblasts synthesize new bone matrix

Quiescence: osteoblasts become resting bone lining cells on the newly formed bone surface

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9
Q

risk factors of osteoporosis

A

non- modifiable: previous fracture, parental history, early menopause, age, female gender
modifiable- low BMI, smoking, alcohol intake

coexisting disease- diabetes, RA/SLE, IBS, chronic liver disease, asthma, HIV

drug therapy- long term antidepressants, PPIs

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10
Q

treatment of osteoporosis

A
  • antiresorptive (reduces bone turnover): bisphosphonates, denosumab, romosoumab

anabolic (stimulates bone formation)- romosozumab, teriparatide

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11
Q

sacropenia

A
  • progressive/generalised skeletal muscle disorder. associated with increased likelihood of adverse outcomes including falls, fractures, physical disability/mortality
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12
Q

treatment of sarcopenia

A
  • resistance of aerobic exercise
  • increased protein intake
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